Quiz: Neuro-ophthalmology

History: This 89 year-old female presents with a complaint of blurry vision and seeing multiple colors in both eyes for the past day. In addition to the unusual colors, she also reports seeing multiple strange shapes. She denies any pain, floaters, or previous episodes. She has a history of neovascular age related macular degeneration (ARMD) in both eyes previously treated with anti-VEGF and steroid injections. She also has advanced primary open angle glaucoma (POAG) in both eyes for which she is currently taking tafluprost. She is pseudophakic in both eyes. Her visual acuity is Count Fingers at 2 feet in the right eye and 20/400 in the left eye (her baseline). IOP is 13 in the right and 16 in the left. Anterior segment examination is significant for a trace posterior capsular opacification in the right eye. Dilated fundus examination is significant for 0.95 cupping in both eyes with subretinal fluid in both macula. The peripheral retina was flat with no detachment or tears in either eye. A photo of the right eye is seen above.